Compressions for Portal Vein Air Embolism Evacuation

Abstract

Laparoscopic entry into the abdomen with subsequent insufflation can be achieved via an open or closed approach. A risk that is often overlooked as a result of its rarity is a venous air embolism (VAE) from carbon dioxide (CO₂) insufflation. Although both closed and open techniques of entry into the abdomen contribute to an extremely low risk for VAE, when the effects are clinically significant the mortality rate has been reported to be as high as 28%. In this report we present a case of a 64-year-old female who underwent a closed approach for entry into the abdomen for elective hepatic cystectomy, who subsequently went into cardiopulmonary arrest and was found to have imaging findings suggestive of VAE localized to the portal vein. Successful management decisions presented in this case report will serve as possible options for physicians to employ when encountering a similar intraoperative complication.

J Curr Surg. 2021;11(2):42-45
doi: https://doi.org/10.14740/jcs436